Wednesday, 19 April 2017

Treatment of Tennis Elbow

Tennis elbow treatment

Treatment involves reducing symptoms of pain and inflammation through rest and applying ice or cold therapy, then gradually increasing the load through the elbow through exercises to a point where normal training and competition can be resumed.Ice & compression – In the first 72 hours post injury, you should apply the principles of P.R.I.C.E. (Protection, Rest, Ice, Compression and Elevation). Apply a cold compression wrap for no more than 15 minutes as the injured tissues are very close to the skin and do not need longer.

Protection – Wear a specialist elbow brace or support can help reduce the strain on the tendon enabling healing to take place. This works by applying compression around the upper arm which puts pressure on the injured tendon, changing the way forces are transmitted through it allowing the injured tissues to rest.

Rest – this is probably the most impotant part of treatment and is often difficult to do. If you continue to use the painful elbow then it will not recover as quickly and may become chronic and very difficult to treat. Avoid gripping heavy things, opening heavy doors, using a screw driver and of course playing a backhand in tennis.

Sports massage can be a useful treatment for tennis elbow, particularly more chronic conditions. In particular cross friction massage of the tendon insertion but only once the initial inflammation has settled (after 5 day) is done. Place the 2nd finger of your opposite hand on the outside of the elbow and rub across the tendon (painful area) for 5 minutes. Do not press too hard but there may be some mild pain whilst having the area ‘frictioned’. Repeat once a day. Do not carry on with this exercise if the pain worsens after the treatment.

A professional therapist or doctor may prescribe medication such as Ibuprofen to help reduce symptoms in the early stages, however the effectiveness of this long term is disputed. In addition electrotherapy such as ultrasound, laser, extracorporeal shock wave therapy, acupuncture, corticosteroid injections, nitric oxide donor therapy patches, botox injections and autologogous blood injection are all treatments available for treating medial epicondylitis.

Exercises

Both stretching and strengthening exercises are important and provide the foundation of a rehabilitation program. The exercises should be performed as soon as pain allows and then continued until and after full fitness has been achieved.

Wrist extension stretches and exercises are the most important with the aim of gradually increasing the load transmitted through the tendon and its attachment whilst also being within the limits of pain. Isometric (also known as static exercises) are done first and involve contracting the muscles without actually moving the wrist. They should only be started once the initial pain and inflammation has settled down.

Surgery

Both golfers elbow and tennis elbow are approached in a similar manner which it comes to surgery. The vast majority of cases of tennis elbow do respond to conservative treatment of rest, ice, ultrasound and occasionally a steroid injection, however if however if surgery is required then it may be 8 weeks before the patient has recovered. See our interview with Mr Elliot Sorene, Consultant Surgeon who explains when surgery may be indicated and which patients are most suitable.